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Burghölzli-Zürich, 18 April 1908
Dear Professor Freud,
Your last letter upset me. I have read a lot between the lines. I don't doubt that if only I could talk with you we could come to a basic understanding. Writing is a poor substitute for speech. Nevertheless I will try to offer some rather incoherent explanations.
Lecture to laymen. The point was to make the public aware of the psychological connections that are found in psychosis. Hence the strong emphasis on the psychogenic factor. There was no reason to talk about the actual aetiology.
Aetiology of Dem. praec. The aim here was to set out our conception of the aetiology. From lack of analytical experience Bleuler stresses the organic side, I the other. I think very many cases of Dem. praec. are due exclusively to purely psychological conflicts. But besides these there are undoubtedly not a few cases where a physical weakness of some kind precipitates the psychosis. One would have to be a spiritualist to believe in an exclusively psychogenic aetiology here. I never have; for me the “constitution” has always played a fairly significant role. That is why I was actually rather relieved when I saw that you had modified your earlier view of the genesis of hysteria. As you have observed, in discussing the aetiology one gets entangled in the most hopeless difficulties, all of which seem to me to have one point of origin: our totally mistaken conception of the brain's function. Everywhere we are haunted by psyche = substantia, playing on the brain
à la piano. The monistic standpoint—psyche = inwardly perceived function—might help to lay this ghost. But I won't go on philosophizing. You yourself will have thought out the logical consequences long ago. The whole question of aetiology is extremely obscure to me. The secret of the constitution will hardly be unveiled from the psychological side alone.
Amsterdam report. Here I have done bad work, as I am the first to admit. In spite of this I shall be grateful for any crit